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Obsessive-compulsive Disorder

Alternate Names

  • OCD
  • obsessive-compulsive neurosis

Definition

Obsessive-compulsive disorder, also called OCD, is a type of anxiety disorder. A person who has OCD has recurring or repeated obsessions and/or compulsions. Obsessions are thoughts, ideas, or images that persist in the mind.

What is going on in the body?

The exact cause of OCD is not known. Recent studies have shown abnormal patterns of brain activity in people with OCD. The abnormalities occur in a part of the brain called the striatum.
Obsessive-compulsive behaviors may be an attempt by the person to reduce anxiety. People who have OCD are usually distressed because they know that their behavior and thoughts are inappropriate.

Risks

What are the causes and risks of the condition?

The exact cause of OCD is not known. It generally begins in childhood or adolescence. OCD tends to run in families. The sense of helplessness and the impairment with OCD may lead to depression. OCD is often seen together with other psychiatric disorders, such as:
  • alcohol abuse
  • attention deficit disorders
  • depression
  • drug abuse or addiction
  • eating disorders, such as anorexia or bulimia
  • other anxiety disorders

Prevention

What can be done to prevent the condition?

There is no known way to prevent OCD.

Diagnosed

How is the condition diagnosed?

Diagnosis of OCD begins with a medical history and physical exam. There are no specific tests for OCD. The healthcare provider will ask about any obsession or compulsive behavior. OCD is diagnosed if the behaviors take up more than an hour of the day or if they cause real distress.
The Yale-Brown Obsessive Compulsive Scale (YBOCS) is sometimes used to measure the severity of the symptoms. Anxiety scales can also be used. These scales are designed to track response to treatment.

Long Term Effects

What are the long-term effects of the condition?

OCD is considered a chronic disorder. The course of the disorder is variable. Symptoms may come and go, ease over time, or grow progressively worse. Treatment should help the person learn to recognize symptoms before they become severe. If symptoms worsen, the individual may need to resume therapy or medicines.

Other Risks

What are the risks to others?

OCD is not contagious. It does tend to run in families.

Treatments

What are the treatments for the condition?

Treatment for OCD usually involves both therapy and medication
Exposure and response prevention therapy is very useful for treating OCD. In this approach, a person is exposed to whatever triggers the obsessive thoughts. The individual is then taught techniques to avoid performing the compulsive rituals. He or she is also taught to deal with the anxiety.
Cognitive-behavioral therapy is also used to treat OCD. The provider helps the person change his or her attitudes and beliefs. The individual learns to react differently to obsessions or compulsions.
Relaxation techniques may also be helpful. They help the person to control the body's reactions to anxiety.
Following is a list of antidepressant medications used to treat OCD:
  • clomipramine (i.e., Clomid, Serophene)
  • fluoxetine (i.e., Prozac, Sarafem)
  • fluvoxamine (i.e., Luvox)
  • paroxetine (i.e., Paxil, Paxeva)
  • sertraline (i.e., Zoloft)
Medications may take weeks to show any improvement in OCD. If one medicine is not effective, others can be tried.
Neurosurgery may be performed for severe cases of OCD. It is done only if all other treatment has failed and the person is severely disabled.

Side Effects

What are the side effects of the treatments?

Antidepressants may cause mild and usually temporary side effects in some people. Here is a list of the most common side effects:
  • agitation
  • constipation
  • dizziness
  • drowsiness
  • dry mouth
  • nausea

After Treatment

What happens after treatment for the condition?

Treatment of OCD is lifelong.

Monitor

How is the condition monitored?

The person with OCD may have regular visits with the healthcare provider. The provider may order blood tests to monitor the level of medications. Any new or worsening symptoms should be reported to the provider.

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